High Definition Body Contouring – Skin Redundancy vs. Skin Elasticity

Skin Redundancy vs Skin Elasticity in High Definition Body Contouring

High definition body contouring starts by separating two skin findings that are often given the same loose name. Skin elasticity is the way the skin returns after it is stretched. Skin redundancy is extra skin that sits as slack, a loop, or a roll. Fat is judged at the same visit, because the contour depends on the fat that will be removed and on the skin that has to cover what remains.

Fat is removed with ultrasound-assisted liposuction, including VASER liposuction. The removal can be broad, to reduce a whole area, or selective, to show the muscle underneath. The skin decision is the harder one. A plan that names only the fat, and never says whether the skin will recoil or has to be cut away, leaves the result unfinished.

Skin Elasticity on the Vertical Plane

Skin elasticity is read here on the vertical plane. It is the ability of the skin to resume its shape after it has been stretched or compressed. A balloon is fully elastic: press it and it springs back. Modeling clay is the opposite material: it keeps the shape the force left behind. Human skin is neither one. It deforms under a force and then returns after a short delay. That mix of elastic and plastic behavior is called viscoelasticity.

Collagen and elastin are the proteins that set this behavior. Collagen makes up much of the dermis, the underlayer of the skin, and it forms the retaining ligaments that connect the skin to the underlying muscle. Those ligaments create the support web called the fibroseptal network. Elastin behaves more like a rubber band and counters the stretch. With age, collagen can thin and elastin declines, so the same pinch returns more slowly. That slower return is a change in skin elasticity. It is not, by itself, a roll of extra skin.

On exam, elasticity is checked by stretching the skin and watching the return. A prompt return means the vertical looseness can still be tightened. A slow return means the recoil is poor, and tightening has less to work with. The check is done with the patient standing, because a pinch on the table hides the way the skin actually hangs.

Skin Redundancy on the Horizontal Plane

Skin redundancy is extra skin in the horizontal plane. Skin works like a fabric laid over the body. A little extra looks like slack. More extra looks like loops or rolls. Slack can tighten if recoil improves. Loops and rolls do not disappear from tightening alone. Removing them means cutting out the extra fabric. That cutting is excisional skin surgery.

The standing exam shows the difference. Elasticity is a stretch that comes back. Redundancy is a fold that is still there after the stretch is released, or a roll that remains when the patient is upright. Calling both findings loose skin is what mixes up the treatment. One finding needs tightening. The other needs the extra skin removed.

How the Two Findings Are Marked

The marking is done standing, in the round, before any incision is chosen. Rolls and loops are drawn where the extra skin stays after the skin is smoothed by hand. Those marks are skin redundancy. Areas that look loose but spring back when they are stretched are marked as skin elasticity. Fat deposits are marked separately, including the places where muscle should show and the places that only need debulking. Mixing the marks is the error this exam is built to prevent.

A single area can carry more than one mark. The lower abdomen may have a roll below the belly button and, above that roll, skin that still recoils. The roll is redundancy and needs excision. The skin above it may be an elasticity problem and may tighten after the fat is removed. Writing both marks down is what keeps a tuck from being used where tightening would do, and keeps tightening from being used where a tuck is required.

High definition body contouring uses those marks to set the order of treatment. Fat is removed first, so the surgeon can see how much skin is truly extra once the volume is gone. Recoil is then tightened where the mark says the skin can still return. Extra skin is excised only where the mark shows a fold that remained. Doing the excision before the fat is judged can remove skin that would have redraped, and skipping the excision leaves a roll that no amount of tightening will erase.

How the Fat Is Removed First

In high definition body contouring, the fat and the skin are planned together, and liposuction is the tool for the fat. Ultrasound-assisted liposuction lets the surgeon reduce an area fully and, where the muscle should show, take fat more selectively. After that fat is gone, the skin either redrapes over the new shape or it does not. That is when skin elasticity and skin redundancy become a choice of tool rather than a label.

Liposuction removes fat. It does not cut away a roll of skin. A patient who already has folds should hear that limit before surgery. High definition liposuction can reveal the muscle only if the skin that remains is able to lie on it. If the skin is redundant, revealing the muscle without removing that skin leaves the fold in place.

Treatment of Skin Elasticity

Skin elasticity, the laxity of skin that can still recoil, is treated with Renuvion J plasma. Renuvion uses radiofrequency and helium plasma under the skin to tighten the collagen in the dermis and in the retaining ligaments. It is done after the fat has been removed, through the small access already used for liposuction. The treatment is subdermal coagulation, not an excision. The collagen tightens during the treatment, so the change in skin laxity is seen at that time.

This tightening is for skin that can still return toward its shape. It is not a substitute for cutting away a roll. Minimal slack may improve when recoil improves. A loop or a roll is skin redundancy, and it stays until the extra skin is removed. Using Renuvion on a fold that needs excision does not turn that fold into elastic skin.

Treatment of Skin Redundancy

Skin redundancy is treated by surgical excision of the extra skin. The operation is named for the area that holds it. A tummy tuck removes extra abdominal skin. A breast lift removes extra breast skin and repositions the nipple. An upper body lift addresses the upper back and the armpit. A lower body lift addresses the lower back and the flanks. An arm lift, also called a brachioplasty, addresses the arm. A lateral thigh tuck, a buttock tuck, and a medial thigh tuck each take extra skin from those sites. A face and neck lift does the same for the face and neck.

The table is the map used in high definition body contouring when the finding is extra skin rather than poor recoil. Each row is an excision for one region. Tightening is not listed there, because tightening does not remove the roll.

The Circumferential Exam

The exam for high definition body contouring goes all the way around the torso. A roll on the flank changes what the abdomen needs, and laxity on the back changes what the waist will show. Fat is treated with VASER liposuction. Skin that can still recoil is treated with Renuvion subdermal coagulation. Skin redundancy is treated with excision. Leaving one of those three out produces a contour that is smooth in one view and folded in another.

The same patient can need both treatments. The lower abdomen may hold a roll that a tummy tuck has to remove, while the flank may only have laxity that Renuvion can tighten after the fat is gone. Those are two findings and two maneuvers. They can be planned in one contouring operation, and they are not interchangeable. Body contouring that treats the whole circumference is what keeps one side from being corrected while the other side still carries the original problem.